Quote Of The Year

Quotes Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Tuesday, March 31, 2009

Good Heavens! - The Commonwealth Department of Health Prodded into (Very Slow) Activity.

The following tender has just been released by DoHA

ePrescribing and Dispensing of Medicines Benefits Realisation and Implementation Plan

The purpose of this consultancy is to:

1. Identify options for a nation-wide ePrescribing system.

2. Analyse all options and recommend an optimum ePrescribing system.

3. Produce a full Business Case for the preferred ePrescribing system.

4. Provide a Final Report on all activities - the ePrescribing andDispensing of Medicines Benefits Realisation and Implementation Plan.

The consultant must consider these objectives in the context of:

  • the findings of the KPMG Report 'Consultancy in Electronic Prescribing and Dispensing of Medicines (ePrescribing), June 2008';
  • a consumer centred approach;
  • the preservation and protection of the PBS;
  • PBS and non PBS medicines;
  • different prescribing settings, for example general practice, residential aged care facilities and acute care;
  • current jurisdictional and industry initiatives;
  • maximising the effectiveness and efficiency of existing infrastructure;
  • the current and future medication management packages, terminology standards and other relevant information from NEHTA;
  • privacy, consent and security requirements;
  • any required legislative or regulatory changes; and
  • the availability of data to inform National Medications Policy decisions.

Details and the tender can be found here:


It is not often one sees a more dramatic example of the bureaucracy ‘closing the stable door after the horse has bolted’!

The context for the development of the plan is fascinating.

The ePrescribing Plan will need to be developed with regard to:

· the National E-Health Strategy (December 2008);

· industry initiatives;

· the KPMG Report. This report identified that there were potential benefits from the longer term implementation of national ePrescribing and dispensing of medicines that results from the availability of data to support National Medicines Policy (NMP). This tender process seeks to appoint a consultant to addresses the recommendations of the report, which were:

Recommendation 1: That the business case defining the high level, long term costs and benefits for the development of the ePrescribing framework is undertaken.

Recommendation 2: Rather than the identification of specific road testing scenarios, it is recommended that road testing be undertaken within the context of the wider ePrescribing strategic directions described in this report.

Recommendation 3: That the Department undertake a review of options for governance and ownership arrangements for ePrescribing support systems and, separately, for the stewardship of transaction data and information content.

Recommendation 4: That consideration be given to the development of specifications required for enhanced claiming, audit and compliance practices which ensure the integrity of the PBS Program under an ePrescribing environment.

· the National E-Health Transition Authority (NEHTA) work program on eMedication Management and broader building blocks for eHealth. Some of these building blocks are healthcare provider and individual identifiers, identity management, clinical information and terminologies and secure messaging. Any national approach needs to adopt these technical standards and consider the broader eHealth environment.

· the links between ePrescribing and other initiatives that improve the quality and safety of healthcare delivery including the National Medicines Policy (NMP) and Quality Use of Medicines (QUM) initiatives. The potential relationship between ePrescribing systems and QUM principles and a patient centred approach needs to be considered.

· the interest and respective roles of the Commonwealth in administering the PBS as the largest procurer of medicines in Australia and all relevant stakeholders.

Just what sort of view do the bureaucrats imagine the consultants will form regarding industry initiatives and how will these be aligned with public expectation for governance and so on – cited in Recommendation 3 and NEHTA’s work!

This will be quite a challenge indeed!

What is more amazing is that the tender suggesst that the study will take about 34 weeks – not at all unreasonable – but that a key outcome will be that “ ePrescribing and dispensing outcomes to be delivered by the year 2014”

It seems no one is in any hurry here at all!

Can I say what we have is an out of touch and clueless DoHA, caught seriously short by some industry players, playing a just pathetic game of catch-up. A joke!

I despair!



Anonymous said...

"closing the stable door after the horse has bolted"! ......... you mean after whole herd of wild brumbies have bolted. The Minister has been let down big time by her bureaucrats. Jane Halten's head should be the first to roll and thrown overboard.

Anonymous said...

Oh dear, oh dear, these people are so very stupid. Do they really think they can develop a system which in some way will replace or displace these commercial initiatives? It doesn’t really matter how much hype is behind the systems that have just been launched, for as time goes by these commercial systems will improve, bit by bit, and their customers will become locked in one way or another.

So when DOHA or NEHTA or some other bunch of government dimwits comes along with “the taxpayer developed alternative” what do you think will happen? Well, because the bureaucraps are so intensely stupid let me tell you.

The government, Medicare or DOHA, will announce its you-beaut eprescription system for doctors, pharmacists and consumers to use. Now, the medical software vendors will have to co-operate and get their software company to interface into this terrific new government system and the same will apply at the other end where the pharmacy software company will have to provide an interface linkage into the new government system.

Lots of juicy PIP, PIP, ePIPs will be offered as enticements to move away from the commercial system to the government system. And of course, the software vendors will all rush to cooperate and help their customers shift over to the dark side, won’t they?

Not on your nelly. You have got to be dreaming. Face the facts - the Department of Health & Ageing and Medicare have had 8 years to get this right; NEHTA has been at it for 4 years. They couldn’t do it then, they can’t do it now and they never will. They have missed the boat and been done like a dinner. All power to the Guild’s eRx system, and to the RACGPs Medisecure system I say.

Anonymous said...

RFT - Really Frightfully Tragic dear chap, is a polite way of saying Really F…..g Tragic.

Anonymous said...

Quote from the RFT: "Following Departmental consideration of the interim report, and approval of a preferred option, produce a business case for the
preferred ePrescribing system in light of the interim report findings. Discuss the benefits and disadvantages of the preferred option and explain and cost the processes necessary to implement the preferred ePrescribing system."

So what is the preferred option - eprescribing system !!!!!!!

Develop another business case!!

Good heavens, haven't we had enough of business cases? Is this all these bureaucrats can do - call for one business case after another?

Where is the system design?
What is the architecture?
What is the environment?

What about designing the system, then costing the development, implementation and rollout?

What about developing the strategies for implementation, market uptake and rollout?

Anonymous said...

How well planned is this? DOHA can’t be doing this on its own - can it?

NEHTA and MEDICARE have to be involved which means they have finally got together to respond to all the adverse media and blog coverage with this RFT.

Anonymous said...

Industry makes a move - like eRx and Medisecure. DOHA awakens from its slumber, digs out the KPMG Report, and rushes out to an RFT. How good is that?

Anonymous said...

The Minister has been well and truly hogtied and suspended by her RFT (very painful) in the middle of the battlefield.

She will now be used for target practice by warring factions representing the Pharmacy Guild’s eRx Script Exchange and the RACGP’s MediSecure. The war is underway.

Anonymous said...

First FredHealth set up eRx with a little help, like millions of dollars, from the‘Friends of FRED’ at the Guild. Then CORUM joined the party. If MINFOS joins in all the large pharmacy dispense vendors servicing 95+ percent of the market will have joined up.

Anonymous said...

Sometimes it is necessary to let the horse bolt before one closes the stable door. This is one of those times.

If the horse had not bolted DOHA, NEHTA and MEDICARE would still be sitting on their proverbials doing sweet FA.

The horse has been whipped hard, it has bolted and is galloping fast towards the distant horizon, and the Government is now in hot pursuit - at last.

There is no turning back, it's first to the winning post.

Anonymous said...

The Guild fired the first shot.

Meanwhile, down the road, the sleepy doctors awoke and stared through their proctoscopes in disbelief; having sighted the Guild’s big pile of poo sitting in front of the fan. Hastily, withdrawing their trusty proctoscopes and running for cover, the RACGP rips the covers off its Weapon of Mass Destruction - MediSecure.

Then the men from the Guv’mint arrive. Ullo, ullo, ullo, what ave we hear? Someone turn on a fan did they? Oh, what a mess, I guess we’ll have to clean it up. Now where did we put that KPMG Report (June 2008) and the MediConnect Field Test Report (2005)? We’d better get moving and pick ourselves up ...... and start all over again. An RFT - that’ll do the trick - perfect.

As a commentator Wednesday, March 25, 2009 10:10:00 AM said “the message from the guild and its partners is clear - surrender or die. This is war and we will win. You have no option but to join us”. ........... or catch us if you can.

Anonymous said...

Don’t you just love this upyou announcement by Graham Cunningham - Chairman eRx said "We welcome the move by the government to learn more about e-prescribing and in particular the approach taken by eRx Script Exchange. We look forward to working with the government appointed consultants to demonstrate how industry lead e-health initiatives such as eRx can rapidly deliver benefits and improve patient health outcomes.

Anonymous said...

What do you mean Wednesday, April 01, 2009 8:44:00 AM - IF - MINFOS joins in all the large pharmacy dispense vendors servicing 95+ percent of the market will have joined up.

We already have joined. “minfos® jumps on board eRx Script Exchange Australian pharmacy management software company minfos® has joined with eRx Script Exchange in rolling out e-scripts throughout Australia. With the inclusion of minfos® in eRx Script Exchange e-prescriptions will be available to 99% of Australian pharmacies during 2009.”

Anonymous said...

eRx Script Exchange. What is it? A royal flush? Full house? Or three of a kind?

Anonymous said...

I would have thought this piece of work would fall under NEHTA's medication management team. If they haven't already identified options for ePrescribing, developed a business case etc then what exactly have they been doing all this time???

Plus NEHTA have already done a benefits realisation plan for eHealth which from looking at the graphs on the slideshow, included ePrescribing.

Anonymous said...

So much for Cunningham's announcement. MediSecure can't be far behind. It looks as though both parties will make love in time - particularly if one keeps the loyalty of the pharmacy vendors and the other the loyalty of the medical vendors. But, then we mustn't forget the real game afoot is to inveigle Government into embracing them both - at a price of course - transaction fees perhaps?

Anonymous said...

Hang on! Hold the phone! This is April Fool's Day. Careful now or is it another CYA management initiative/objective/outcome [choose which ever is appropriate].

CYA = Cover Your Ar*e

Anonymous said...

Wednesday, April 01, 2009 10:19:00 AM is right, it does fall under NEHTA's medication management team headed by Toby Matheison. But DOHA would have to get the funds and there is no way DOHA will call and RFT without the full involvement of both NEHTA and MEDICARE. They couldn't be so stupid. DOHA and NEHTA have to work closely together and because MEDICARE pays out on the PBS it too has to be involved in something as important as this RFT.

Anonymous said...

The doctors' side holds the Aces. The doctors create the script, they can choose to send it to 'an exchange'. Most will choose the MediSecure Exchange.

The pharmacists will pull it in provided someone pays the 25 cents.

The Guild will arrange for that to happen in the new 5th Agreement due in June 2010. The Guild's opening gambit will probably be $1.25 per script settling out at around 75 cents per script if it can't do any better.

Of the 75 cents, 25 cents will go to MediSecure, 25 cents will go to the Medical Practice and 25 cents will go to the pharmacist. At 75 cents and 100% market share the Government will pay out $120,000,000. And, everyone will be happy except the Government. How about that. oops - not sure if eRx will be happy but the Guild will findaway - it always does.

Anonymous said...

Sounds good all round (nearly). I mean it's only a 2% increase on the $6 billion PBS. Only 2%. I mean, $120 million is a lot less than the Department has already spent on NEHTA and HealthConnect. So why worry, who cares, what's a measly 2%?

Anonymous said...

Why doesn't the government just contract the eRx vendor outright? Skip the rubbish about yet another business case.

Looks like eRx has the Guild and all the pharmacy software vendors on board already anyway. Don't know if there's really much to MediSecure except some press releases and cronyism, but if needs be buy them both!

Would save tens of millions of dollars in wasted bureacratic effort and years of bungling!!

If the private sector can do this better, then wake up and take advantage of that.

Anonymous said...

Well they've well and truly woken up alright but there is nothing to stop them dropping dropping off to sleep again.

But what would they get if they bought either or both. A bit of untried and unproven software on both sides. As for press releases and cronyism - isn't that more like the Guild's domain?

Anonymous said...

According to Pulse+IT just now, minfos has committed to both hubs:


Anonymous said...

It is quite horrific to think that after reflecting on the RFT, reviewing the list of stakeholders, considering what could be excluded for the document and what should have been included in the document I have to come to the most unpalatable conclusion, that:

(a) despite all the criticisms and constructive suggestions from many well qualified and intelligent experts on how to approach the problem no-one has listened and as a consequence no new thinking has been brought to bear in that regard

(b) this RFT will mark the start of a repeat of the failed attempts of years past.


Withdraw the RFT and get some experts capable of bringing substantial new thinking to the problem.

Anonymous said...

And here's the odds for the betting pool:
10 to 1 for Medisecure
100 to 1 for Guild's eRx
DOHA RFT - scratched because it is unfit but you don't get your money back sorry
You can be sure it will be an exciting race that will set your pulse racing, and the winner will just PIP the runner-up at the post.